Healthcare Provider Details

I. General information

NPI: 1326687765
Provider Name (Legal Business Name): DOULAS OF ORLANDO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6644 GUNNELL CT
ORLANDO FL
32809-6525
US

IV. Provider business mailing address

PO BOX 593743
ORLANDO FL
32859-3743
US

V. Phone/Fax

Practice location:
  • Phone: 321-804-2969
  • Fax:
Mailing address:
  • Phone: 321-804-2969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: MARIA Y LUNA
Title or Position: OFFICE MANAGER
Credential: CD (DONA)
Phone: 321-804-2969